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OncoMatch/Clinical Trials/NCT06537154

NEO-BLAST: Neoadjuvant Therapy for Bladder Cancer Followed by Active Surveillance vs Treatment

Is NCT06537154 recruiting? Yes, currently enrolling (May 2026). This Phase 2/3 trial studies non-drug interventions for muscle-invasive bladder carcinoma.

Phase 2/3RecruitingPeter BlackNCT06537154Data as of May 2026

Invasive bladder cancer is managed with neoadjuvant therapy followed by bladder removal (cystectomy). Research shows that approximately 40% of patient will have no remaining cancer left in their bladder after completion of the initial systemic treatment, and perhaps could have avoided the surgery. However, currently physicians lack the ability to identify these patients. The investigators believe that by using advanced imaging (MRI), bladder biopsies and novel biomarkers that detect tumor DNA in blood, they can better identify participants without any remaining cancer after chemotherapy. This will make active surveillance of these participants safer. In this study, participants without evidence of residual cancer will be randomized to active surveillance vs conventional bladder treatment (bladder removal, or chemo-radiation of the bladder). This study will be a pilot randomized control trial (RCT), and if successful, it will transition to a larger phase 3 RCT.

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Extracted eligibility criteria

Cancer type

Urothelial Carcinoma

Performance status

ECOG 0–2(Ambulatory, capable of self-care)

Prior therapy

No prior treatment (treatment-naive required)
Max 0 prior lines

Cannot have received: systemic chemotherapy

Prior systemic chemotherapy

Cannot have received: immunotherapy (anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4)

Prior immunotherapy (an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways)

Cannot have received: antibody-drug conjugate (NECTIN-4, HER2)

antibody-drug conjugate (NECTIN-4, HER2 or other)

Cannot have received: cytotoxic chemotherapy

cytotoxic chemotherapy, immunotherapy or other targeted therapy for another malignancy within 2 year of study entry

Cannot have received: radiation therapy

Prior radiation therapy for bladder cancer

Cannot have received: experimental agents

Participants who have received experimental agents within 4 weeks of study entry

Structured fields extracted by AI. May contain errors — verify against the official protocol.

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